This study presents the results of a systematic review of the literature examining the factors that contribute to the effectiveness of augmentative and alternative communication (AAC) devices in people with aphasia. A comprehensive electronic and hand-search of the literature published between 2000 and 2014 was conducted to identify relevant studies published in peer-reviewed journals. All studies meeting the inclusion/exclusion criteria were appraised for quality and categorized. The review identified seven studies related to the research question, involving 58 participants with aphasia involved in treatments related to the acquisition, use and generalization of AAC devices. This review revealed that many of the studies were case studies or quasi-experimental studies, and while many of the results during treatment were promising, many of the patients with aphasia did not generalize their devices to everyday communication which therefore led to abandonment of the AAC device. Additional research using more effective generalization strategies and more controlled experimental studies are needed to establish a more effective AAC device for this population. This analysis was then compared to current apps and dedicated devices to determine supports and limitations inherent in designs.